Post on 24-Jun-2020
Page 1 of 43
Medical Assistant Project Report:
Workflow Optimisation in General Practices in Surrey Heath
Executive summary This report provides a full description of the Medical Assistant Project including closure of the project and transfer to business as usual. Funding was provided by Health Education England, Kent Surrey Sussex following bid submission by the GP Federation in Surrey Heath (Surrey Heath Community Providers Ltd). Project aims and objectives were clearly defined in order to reduce the administrative burden on General Practitioners (GPs) and to enhance the skills of administrative staff. The project ran for 12 months during which time staff were provided with training to identify correspondence that could be placed directly into patient records and also highlight documents to be reviewed by General Practitioners. In addition, practice managers and GPs received training in order to be able to provide support and supervision of administrative staff. The training was rolled out across all 10 sites (8 practices) in Surrey Heath and positive feedback was received from the majority of participants. Following initial training the project team agreed to develop its own training package for future utilisation and this work is complete. All practices went live with the new processes during January and February 2018. A survey of staff satisfaction has proved extremely positive and further evaluations are planned in order to provide a full evaluation of the work to date and to demonstrate full benefits realisation. Final conclusions demonstrated an extremely positive outcome with the project delivering an 85% reduction in correspondence work flow to GPs and an 85% saving in GP time managing correspondence. This equates to an approximate time saving equivalent to 34 hours of GP time per working day across the Surrey Heath geography. The project delivered within financial resources and to timescale. The project has transferred to business as usual with recommendations that the practices would need to identify additional administrative resources and increased scanning capacity.
Acknowledgement: Surrey Heath Community Providers Ltd would like to thank NHS Surrey
Heath CCG for contributions and support to the project.
Page 2 of 43
Contents
Executive summary ............................................................................................................................. 1
1.0 Introduction ............................................................................................................................ 3
1.1 Purpose ................................................................................................................................... 3
1.2 Background ............................................................................................................................. 3
1.3 Aims and Objectives ................................................................................................................ 4
2.0 Project Approach Detail .......................................................................................................... 4
2.1 Project Governance and Structure ......................................................................................... 5
2.2 Procurement ........................................................................................................................... 6
2.3 Correspondence Scoping ........................................................................................................ 7
2.4 Recruitment ............................................................................................................................ 7
2.5 Communication ....................................................................................................................... 8
2.6 Training .................................................................................................................................. 8
2.6.1 External Training Materials ................................................................................................. 9
2.6.2 Sustainable Future Training ................................................................................................ 9
2.6.3 Training Feedback ............................................................................................................... 9
2.7 Project Metrics ...................................................................................................................... 10
2.8 Finance .................................................................................................................................. 14
2.9 Go Live, Evaluation & Transfer to Business as Usual ............................................................ 14
2.9.1 Soft Go Live ....................................................................................................................... 14
2.9.2 Go Live ............................................................................................................................... 14
2.9.3 Evaluation.......................................................................................................................... 15
3.0 Project Risks .......................................................................................................................... 15
4.0 Issues Log .............................................................................................................................. 15
5.0 Lessons Learned Log ............................................................................................................. 15
6.0 Conclusions ........................................................................................................................... 15
7.0 Recommendations ................................................................................................................ 15
8.0 Table of Appendices .............................................................................................................. 16
9.0 Contact Details - Surrey Heath Community Providers Ltd .................................................... 16
Page 3 of 43
1.0 Introduction 1.1 Purpose The purpose of this document is to outline the Surrey Heath Medical Assistant Project and present the progress made in the form of pre- and post-project results and impact.
1.2 Background In December 2016 an opportunity to access funding from Health Education England, Kent, Surrey and Sussex (HEEKSS) was identified via the Surrey CEPN (Community Education Provider Network). A funding bid was developed by the local GP Federation, and was endorsed by the Surrey CEPN before being submitted. The bid proved to be successful, securing £25,500.00 to deliver the project. In Surrey Heath the primary care medical practices are working together as a Federation. At that time (as two practices have since merged) the Federation comprised 8 practices providing services from 10 surgery sites. The Federation is officially known as Surrey Heath Community Provider’s Ltd (SHCPL), and will be referred to as ‘the Federation’ within this document. The Federation works closely with NHS Surrey Heath Clinical Commissioning Group (SHCCG, the CCG) to understand the demands, time and workforce pressures and the needs of general practice in order to determine best placed supportive solutions. It is well-recognised that the general practice workforce is under pressure, which was a significant motivation to deliver this project. At project initiation the Surrey Heath area had approximately 54 full time equivalent (FTE) General Practitioners (GPs) (1). Surrey Heath practices had a small number of vacancies across the GP workforce (1), and were beginning to feel some of the recruitment pressures faced elsewhere in the country. As a consequence the Federation were keen to explore opportunities to reduce the workload in order to support the working experience and effectiveness of existing GPs in the system. A report commissioned by Health Education England (HEE) says that GPs spend 11% of their time on administrative tasks (2). The introduction of the correspondence management skill set within administrative and clerical staff, known by HEE as ‘Medical Assistants’, would support the increase of GP capacity by freeing up the time currently being used for administrative tasks (2). The findings of the Primary Care Workforce Commission (2) suggested that in Surrey Heath this could create approximate additional GP capacity of between 3 and 6 full time equivalents (FTEs). This is potentially significant capacity which could be utilised to increase GP time to focus on clinical tasks within their working day. The Federation has a proven track record of achieving and sustaining innovation through collaboration and has achieved significant clinical engagement and collaboration across the Surrey Heath footprint. For example, the Federation has already worked with practices to deliver 08:00 – 20:00 extended access to general practice since April 2015. 1 Health Education England, Kent, Surrey & Sussex, GP Workforce Tool – as per practice data for Surrey heath
at Quarter 3 2016/2017.
2 The Primary Care Workforce Commission, 2015, The future of primary care; Creating teams for tomorrow
Page 4 of 43
1.3 Aims and Objectives The project had two main aims:
1. To reduce the administrative burden on clinical staff in general practice, specifically medical staff (GPs), and
2. To enhance the skills of administrative staff in the practices. The objectives the project sought to deliver were:
To increase the GPs’ experience of working in Surrey Heath,
To support recruitment; make general practice in Surrey Heath a more attractive place to work (for both clinical and non-clinical staff),
To retain skills, knowledge and experience within the existing workforce; support the retention of the 12% of GPs who are over 55 years old and approaching retirement,
To support the standardisation of correspondence management across footprint; sharing best practice ways of working with all practices.
To enable the wider Multi-disciplinary Team partners to support patients to maintain independence and avoid unnecessary hospital admissions.
2.0 Project Approach Detail The project funding was to allow senior administrative staff (those supervising and line managing administrative staff) and the nominated GPs to provide the support and governance for this new way of working in the Surrey Heath practices. The project was to be co-ordinated by the Federation which was already demonstrating collaboration, willingness and success in engaging with system partners. Previously the majority of correspondence management was undertaken by GPs, which saw GPs reviewing clinical correspondence which often required no clinical response or action other than filing as part of the patient’s records. This often meant GPs dealing with many 10’s of individual items of correspondence, which consumed a significant amount of clinical time. There was some experience of limited levels of correspondence management being undertaken by non-GPs in the system and the Federation recognised the potential to significantly scale up this approach to release GP time. The programme aimed to train administrative and clerical staff members from each practice to be able to undertake correspondence management that would traditionally have been undertaken by the GPs. The programme also sought to provide training to GPs and senior administrative staff from across the Federation to support the successful delivery of the new skills learnt by the administrative staff from all the practices. The GPs and senior administrative staff trained will provide the ongoing supervision and support to the Medical Assistant staff to ensure long term confidence and competence within the role. As an additional benefit to the NHS primary care medical system in England, this project has the potential to provide valuable learning through the ongoing evaluation shared with Health Education England, Kent, Surrey and Sussex. This learning could support other areas
Page 5 of 43
looking to develop such roles and skills, or looking for strategies to manage the workload of GPs. A faculty of ‘Train the Trainers’ was developed as part of the project. These trainers will be a resource for ongoing training to maintain the medical assistant resource within the Federation, but also a resource to others within the Surrey Community Education Provider Network, Sustainability and Transformation partnership, and across other Health Education England regions.
2.1 Project Governance and Structure The initial project plan was developed and signed off by Dr Mark Pugsley, Clinical Director of Surrey Heath Community Providers Ltd (SHCPL), and Miss Netty O’Conor, Non-Medical Director of SHCPL. The Federation established a Project Team, which included CCG representation, to provide oversight and management of project progress, issues and risks. Table 1: Project Team: Name Organisation
Director (Federation) GP Federation
Director (Federation) GP Federation
Head of Workforce & Nursing CCG
Project Manager Provided by the Federation
The project funding included specific resourcing for Project Management. This was felt to be essential to the success of the project, and was expected to provide the following:
To be responsible for the day to day management of the project and for ensuring that the project team, senior users and end users of the system are aware of their roles and responsibilities. The Project Manager’s day to day management responsibilities included:
o The planning, monitoring and control of all aspects of the project and the motivation of all those involved in it to achieve the project objectives on time and to the specified cost, quality and performance
o Producing and maintaining the Project Plan ensuring all stakeholders are aware of their responsibilities, deadlines and budgets
o Production of the Project Brief o Production of the Project Initiation Document. o Monitoring the project plan and providing status reports to the Project Board
and key stakeholders, highlighting risks to achieving deadlines within allocated budgets in a timely manner and keeping the project on track
o Ensuring operational decisions are implemented promptly and effectively o Regular communication between all stakeholders
Page 6 of 43
o Managing the ‘change control’ procedure for the project o Ensuring operational compliance with applicable laws, regulations,
information and security requirements The programme was monitored by the Project Team, with regular updates provided to the Surrey Heath practices via a number of forums; Surrey Heath GP Steering Group (which is hosted by Surrey Heath CCG), Protected Learning Time Events, and internal electronic communication. Initially the Project Team met fortnightly, and this frequency reduced to monthly as the project developed. The Project Governance documents included:
Project Board meeting notes
Project Board Action Tracker
Project Plan (Appendix 1)
Project Issues Log (Appendix 2)
Project Risk Register (Appendix 3)
Project Lessons Learned Log (Appendix 4)
Project Communication Plan (Appendix 5)
Project Finance (Appendix 6)
A number of project Key Performance Indicators (KPIs) were also developed to ensure the project had the ability to measure its impact (see section 2.7).
2.2 Procurement The initial project scoping, which informed the funding bid, explored providers with off-the-shelf programmes available to train staff in the management of clinical correspondence, to provide training for an internal train-the-trainer faculty, and also covering the associated practice governance required to implement and manage the change to ways of working. Two providers were able to offer products to meet our needs. The table below shows the provider responses: Table 2: Programme provider costings: Provider Cost
1 Provider ‘A’ (costing model - £0.40 per registered head of population)
£38,800 (based on indicative registered population of 97,000
2 Provider ‘B’ £5000 (fully inclusive)
Members of the Project Team met with both providers and based on cost and provider offer chose to procure the training package from Provider ‘B’. Due to the cost of the preferred provider the two quotes were sufficient, and no broader procurement process was necessary.
Page 7 of 43
The chosen product delivered four levels of training to build basic knowledge and understanding of medical terms and language, through to managing practice governance around the new way of working, and train the trainer skills.
2.3 Correspondence Scoping To determine which types of clinical correspondence would be within scope of the project a process of data collection of current activity was undertaken. This information was then used to build and agree a local protocol and procedure for the Medical Assistants. A copy of the data collection template can be found at Appendix 7, and a copy of the Protocol can be found at Appendix 8.
2.4 Recruitment The training was delivered in cohorts of each of the required training levels. The training dates for each level of training were advertised to each practice for staff to be identified and booked on. The table below shows the training capacity and uptake. Table 3: Training capacity and uptake: Training Level Capacity (people) Number
attended Percentage drop out (non-attendance)
Percentage Uptake
1 (choice of 2 dates)
50 40 4% 80%
2 (choice of 2 dates)
50 45 4% 90%
3 (1 date) 30 24 0% 80%
4 (1 date) 20 20 0% 100%
GP Champion training
8 (1 per practice)
8 0% 100%
Total: 158 137 4% 90% (average)
In terms of the reach of training, on average 13 staff at each surgery site have received some level of training. One practice manager felt they did not want to change their flow of correspondence and therefore felt they didn’t want to participate in the project, but still wanted to send staff on the training. However, as the project progressed the practice has fully embraced the changes. Not all capacity was utilised for levels 1 and 2. It was felt that this was natural slack in capacity where the project team had been overly optimistic when planning capacity. When looking for lessons to learn, the Project Team identified:
1. The project team recognised that the communication around the levels of training could have been clearer. It was felt that increased clarity around the description and
Page 8 of 43
implications for practice of each of the ‘levels’ would have improved the learner preparedness for the training and potentially improved uptake.
2. Concern had been raised by the project team regarding the appropriateness (background, role, and in-role capabilities) of some of the delegates being booked onto the level 4 training (train-the-trainer). Prior to the delivery of the level 4 training the project team delivered additional communication to practices outlining the specific anticipated responsibilities of staff attending the level 4 training. Specifically, this was clarifying that staff attending level 4 training would be expected to form the faculty of train-the-trainers for future training delivery.
2.5 Communication The Project Team recognised the importance of effective and sufficient communication in relation to the success of the project. A Communication Plan was established as an early priority, and can be found in Appendix 5. Communication was aimed at internal staff within the general practices associated with Surrey Heath Community Providers Ltd. Methods of communication were oral presentation at a number of Federation and CCG events, supported by email and via staff meetings and professional forums. When looking for lessons to learn, the Project Team identified:
The project team had anticipated that GPs would be keen to support the project on the basis of the expected aims and objectives. However, some initial feedback was not as positive as expected. Consequently, the Project Team undertook some additional and targeted engagement with GPs via the CCG’s GP Steering Group which identified support for the planned GP Champion training. The GP Champion training then went on to have 100% uptake of places.
As referenced under section 4.4 one practice manager was initially disengaged with the project. This was potentially disruptive to successful delivery across all sites, therefore the Project Team felt it would have been more effective to have sought firm commitment from practices during the launch engagement work and to have had the opportunity to work through any resistance or scepticism at that early stage.
2.6 Training As described in section 4.4 the training was delivered at the four individual levels over a period of seven days. The seven days were spread over a period of 4 months. This was to enable the release of significant numbers of staff from small practice teams without disrupting the delivery of services. The Project Team had agreed with the training provider that all training materials would be shared with the Project Team in advance of the delivery of training. This was to enable the Project Team to provide some quality control, to ensure the content was appropriate to practice staff and that there was no messaging or phrasing that might have a negative impact on the audience.
Page 9 of 43
The training provider came to a local site chosen by the Project Team for all the sessions, and the same external trainer delivered all sessions to ensure consistency. The cost of training venue and refreshments was covered by the project funding.
2.6.1 External Training Materials The Project Team experienced a number of issues with the training provider (see Appendix 2). For example, the Project Team repeatedly did not receive copies of training materials prior to training sessions. The training provider was repeatedly reminded, but still failed to send presentation material through in advance on a number of occasions or sent the material through the evening before sessions were due to be delivered. Unfortunately, the quality of some of the materials was not up to the standard expected by the Project Team which led to material being used with spelling mistakes and advertising for other training products from the provider. On one occasion the Project Team received the training materials in advance and chose not to allow the material to be used due to the number of errors contained.
2.6.2 Sustainable Future Training The Project Team engaged the skills and expertise of an external independent training expert to support with the development of resources for the train-the-trainer faculty. These resources are to enable future training to new staff as they come to work in practices in Surrey Heath. There is also the potential for the Federation to provide the training to practices outside the Surrey Heath geography. When looking for lessons to learn, the Project Team identified:
Some staff who have been trained as train-the-trainer have since articulated that they don’t feel comfortable to stand up in front of colleagues outside their practice and deliver the training to them. This has meant that the train-the-trainer faculty is smaller than the original number trained.
It is worth noting that those who opted out of delivering external training are still happy to train and support those within their own practice (surgery).
To manage this and enable capacity for delivery of training across all practices, the GP Federation have identified an independent trainer to co-deliver some of the external sessions supported by an in-house trainer / Federation member.
2.6.3 Training Feedback All training sessions were evaluated. Delegates were surveyed before and after each session. Copies of the pre and post surveys and the results of the surveys can be found in Appendices 9, 10, 11, 12. Table 4 shows some of the data obtained via the training feedback forms, captured on arrival for training sessions, and again at the end of the training sessions.
Page 10 of 43
Table 4: Delegate training feedback responses: Questions Average score
before project Average score after project
Sample of questions asked to course delegates: Score out of maximum of 6
How would you rate the potential for correspondence management to make a real difference to how your practice currently works?
3.72 5
How would you rate the potential for correspondence management to improve the quality of patient care your practice offers?
3.64 4.89
How would you rate the potential for correspondence management to increase your level of job satisfaction?
3.29 4.32
Sample of questions asked to Practice Managers, Line Managers, Supervisors:
How would you rate the potential for correspondence management to make better use of GP time in your practice?
3.64 5.25
How would you rate the potential for correspondence management to increase the level of job satisfaction within your team?
3.23 4.2
What is noticeable across all questions is that the ‘after’ score for every question was higher than the ‘before’ score.
2.7 Project Metrics A set of Key Performance Indicators (KPIs) were developed to support measurement of the impact of the project. The metrics identified were:
% take up of training by staff group
% drop out
% trained who do not utilise
Number of complaints related to correspondence
Number of significant events
Number of letters work-flowed to doctors
Drop-out rate from train the trainer
Staff Satisfaction
GP Satisfaction The KPIs were plotted on a Benefits Dependency Network (BDN) diagram to ensure they would provide measurement to support the project aims and would be delivered through the planned work streams. A copy of the BDN can be found at Appendix 13. A baseline set of KPIs was captured prior to implementation (Go Live), and the first set of post-implementation KPI data was captured in March 2018. Tables 5 to 13 show the data for each project metric.
Page 11 of 43
Table 5: ‘Percentage take-up of training by staff group’: Staff Group No. in staff group invited
(average) No. in staff group attended
% Uptake
Admin & Clerical 43 36 84
Managers 8 8 100
GPs 8 8 100
Table 6: ‘Percentage drop out’ by staff group:
This metric refers to staff who commenced but failed to complete their relevant suite of training. Staff Group No. Staff
commenced No. Staff who completed
No. drop out % drop out
Admin & Clerical 38 36 2 5
Managers 8 7 1 10
GPs 8 8 0 0
Table 7: ‘Percentage of those trained who do not utilise’:
Staff Group No. Staff trained No. Staff utilising No. not using % not using
Admin & Clerical 36 31 5 14*
Managers 7 7 0 0
GPs 8 8 0 0 * there was a cohort of administrative and clerical staff who attended the course to gain an understanding of medical language which was delivered in the Level 1 training. However, these staff were not expected to work as correspondence managers/Medical Assistants following the training.
Table 8: ‘Number of complaints related to correspondence’: Number in the 12 months
prior to project Number 6 months post implementation (Jan to June 2018)
Number in the year across all practices
3 0
Table 9: ‘Number of significant events’: Number in the 12 months
prior to project Number 6 months post implementation (Jan to June 2018)
Number in the year across all practices
4 0
Page 12 of 43
Table 10: ‘Number of letters work-flowed to doctors’: No. letters in
Docman per day ‘Before’
No. letters in Docman per day ‘after’
Time spent per day ‘before’ (mins)
Time spent per day ‘after’ (mins)
Average across all GPs 33 5 41.15 6.15
This metric aimed to directly measure the goal of the project to reduce the number of letters work-flowed to GPs. The project demonstrated significant impact against this measure, showing an 85% reduction in both the number of letters work-flowed to GPs and the amount of time spent on correspondence. This equates to an average time saved of 35 minutes per day per GP, based on observational assessment of individual GP activity of a sample of GPs across the geography, which showed an average time spent per document of 75 seconds. Based on the local GP workforce of 58.56 full time equivalents in Surrey Heath at the end of the project (3) (which has increased since project initiation), the project has delivered an approximate time saving of 34 hours of GP time per working day across the Surrey Heath geography. 3 Health Education England, Kent, Surrey & Sussex, GP Workforce Tool – as per practice data for Surrey heath
at Quarter 2 2017/2018.
Table 11: ‘Drop-out rate from train the trainer’:
Staff Group No. Staff commenced
No. Staff who completed
No. drop out % drop out
Managers 8 7 1 10
Table 12: ‘Staff Satisfaction’: All Administrative and Clerical staff undertaking the document management process in practices were asked to complete a post-implementation questionnaire, to seek to understand their perception of the impact of the model of correspondence management. A blank questionnaire template is available at Appendix 14. A sample of the role satisfaction questions asked in the questionnaires, and associated responses, are summarised below: Disagree Somewhat
disagree Somewhat agree
Agree
I am more satisfied with my work 0% 0% 100% 0%
I am more likely to stay in this work setting
0% 0% 75% 25%
Page 13 of 43
Examples of narrative feedback from Administrative & clerical staff are:
“Doctors don’t have as much paperwork to do”
Makes it more streamlined”
“Doctors have more time to do other important things”
Table 13: ‘GP Satisfaction’:
All GPs were asked to complete a questionnaire, post implementation of the new way of working, to seek to understand their perception of the impact of the model of correspondence management. A blank questionnaire template is available at Appendix 15. Disagree Somewhat
disagree Somewhat agree
Agree
I spend less time on correspondence since the programme started
0% 0% 15% 85%
I have more time for other clinical duties
0% 0% 15% 85%
The programme has had a positive impact on my working day
0% 0% 15% 85%
Examples of narrative feedback from GPs are:
“We must maintain this process across all our sites”
“Psychologically so much better to look at Docman list”
“Has reduced document filing to a manageable level”
“Positive, less workload”
Page 14 of 43
2.8 Finance The project was funded with £25,500.00 from Health Education England, via the Surrey CEPN. The Project Team provided oversight of financial management at the regular Project Team Meetings. A copy of the Finance Sheets can be found at Appendix 6. The project came in on budget. Table 14 shows how the planned spend was allocated.
Table 14: Planned spend allocation:
Cost Allocation
£5000 bespoke training
£4000 back-fill time to support release of practice staff and sustainability of service delivery
£3250 Programme Evaluation and development of Train the Trainer toolkit and resources
£6000 Programme Management
£2500 Venue and facility costs
£4750 Costs of learning materials for future Train the Trainer programme
2.9 Go Live, Evaluation & Transfer to Business as Usual
2.9.1 Soft Go Live A ‘soft’ go live was piloted in one of the practices to test for any unforeseen consequences. The soft go live identified significant time savings for the GPs in the practice. However, it also identified additional pressure on the administrative staff in the practice in terms of requiring additional administrative resource at least during the implementation phase. It also identified that practices required additional scanning machines to enable more than one administrator to scan correspondence at any one time. This was a reflection of the fact that administrators now had to spend more time reading correspondence during the scanning process. This was supported by the Clinical Commissioning Group. When looking for lessons to learn, the Project Team identified:
1. The soft go-live practice identified a need for increased administrative staff resource. This has now been experienced by each of the practices, with smaller practices needing up to 1.0 full time equivalent additional resource, and the largest practices needing up to 2.0 full time equivalent resource.
2. Practices have been confident to invest in administrative time based on the significant positive impact on GPs and the release of more expensive GP time.
2.9.2 Go Live All practices identified their own Go Live dates in January and February 2018. This provided practices with a calendar month of live activity prior to the first set of post-implementation data being collected.
Page 15 of 43
2.9.3 Evaluation The Project Team are undertaking the evaluation using the baseline KPIs, first post-implementation KPIs and a final set of KPIs. This will be combined with feedback from future supervision groups delivered post-implementation.
3.0 Project Risks The Project team maintained a Risk Register (Appendix 3). The Risk Register proved to be a useful tool for enabling the Project Team to focus on potential issues and to identify mitigation in advance.
4.0 Issues Log The Project team maintained an Issues Log (Appendix 2). The Issues Log proved to be a useful tool for enabling the Project Team to focus on actual issues and to identify actions to prevent more significant challenges.
5.0 Lessons Learned Log The Project team maintained a Lessons Learned Log (Appendix 4). The Lessons Learned Log proved to be a useful tool for informing approaches to future projects led by the Federation.
6.0 Conclusions The value of this project has been significant in terms of the positive impact on GPs. The project has delivered the approximate time saving of 34 hours per working day of GP time across the Surrey Heath geography. This is based on 35 minutes per day saving across the current local GP workforce of 58.56 full time equivalents in Surrey Heath at the end of the project (based on the latest available data from the Health Education England, Kent Surrey and Sussex GP Workforce Tool at that time). The change to ways of working has increased the job satisfaction for both GPs and administrative and clerical staff. The Project Team would recommend the review of correspondence management workflow, and implementation of similar processes to other general practices.
7.0 Recommendations A number of items of learning and recommendations for the future have been referenced throughout the report. Key recommendations to others would be:
Ensure robust engagement with GPs prior to engagement with other staff, including Practice Managers.
Page 16 of 43
Continuous review of workflow processes, including the review of scope of documents and the ongoing training of staff.
There is value in working closely with the local Clinical Commissioning Group for support.
8.0 Table of Appendices
Appendix 1 Project Plan
Appendix 2 Project Issues Log
Appendix 3 Project Risk Register
Appendix 4 Project Lessons Learned Log
Appendix 5 Project Communications Plan
Appendix 6 Project Finance Table
Appendix 7 Data Collection Table
Appendix 8 Protocol for Document Management
Appendix 9 Surveys (1)
Appendix 10 Surveys (2)
Appendix 11 Surveys (3)
Appendix 12 Surveys (4)
Appendix 13 Benefits Dependency Network
Appendix 14 Evaluation Questionnaire (1)
Appendix 15 Evaluation Questionnaire (2)
9.0 Contact Details - Surrey Heath Community Providers Ltd Postal address:
Surrey Heath Community Providers Ltd Heatherside Surgery 73 Cumberland Road Camberley Surrey GU15 1SE
Email address: enquiries.SHCP@nhs.net Telephone number: 07375646711
Page 17 of 43
Appendix 1. Project Plan
Workstream Dependencies Milestone/Task Lead Start Date DUE Date Date
completed
Governance
Agree project group membership
and establish 1.6.17 26.4.17
Develop and agree project plan 3.8.17 3.8.17
Develop and agree risk register 24.8.17 6.9.17 31.8.17
Initiate Lessons Learned Log 8.6.17 8.6.17
Project meetings arranged 1.6.17 1.6.17
23 Monthly monitoring established 1.6.17
Procurement
Agreed training in budget 26.4.17 26.4.17
Training provider secured 26.4.17 26.4.17
Training evaluated 30.12.17
Recruitment
Agreed application form in place 1.8.17 1.8.17
27
Communication to practices re
applications complete 1..8.17 1.8.17
Completed applications received 1.8.17 25.8.17 25.8.17
Applications review and places
assigned against allocation 1.8.17 31.8.17 31.8.17
Joining instructions provided to
learners 6.9.17 6.12.17
Joining instructions provided 1.9.17 29.11.17 22.11.17
Focus group established
Communication
Develop and agree comms plan 3.8.17 3.8.17
40
PLT/GP Steering Group engagement
complete 20.6.17 31.8.17
Full GP buy-in achieved 20.6.17 31.8.17
Initial Practice Manager engagement 10.5.17
Project Managers' Forum established 26.4.17 26.4.17
Training
16 TNA Agreed 27.7.17 28.7.17 3.8.17
Training Material agreed 8.6.17 9.7.17
Dates for training booked 8.6.17 27.7.17 20.6.17
Venue booked 8.6.17 8.6.17
Training evaluation developed
TTT Material developed 6.12.17 28.2.18 20.4.18
Metrics
KPIs agreed 26.4.17 27.07.17 27.7.17
Metric processes agreed 27.07.17 27.7.17
Draft evaluation forms agreed 24.08.17 24.08.17
23 Baseline data captured 10.5.17 20.5.17
Metrics measured (x3)
Finance
Funding secured 26.4.17 1.6.17 1.6.17
Budget sheet established 1.6.17 24.8.17
Monthly spend review
Income requested 31.5.17 18.5.17
Income received 1.8.17 22.9.17
Project evaluation &
closure
Go live 31.1.18
Develop and agree presentation 15.6.18 19.6.18
Develop and agree project closure
report 15.6.18 19.6.18
Evaluation complete 30.6.18 19.6.18
Formulate plan for BAU 30.6.18 19.6.18
Page 18 of 43
Appendix 2: Project Issues log
24/05/2018
Related Risk No. Issue Type Issue Description Date Raised Issue Owner Actions Action OwnerDate for Actions to
be ImplementedUpdate Open/Closed Reason for closure
if applicableA statement describing
the cause of the issueDate issue raised Actions that are operating that deal with the issue
Job title of the person
assigned to carry out actions
For each action a
completion date must
be provided
Issues should be prioritised as
high, medium or low. A full list
is given in the guidance tab
Operational One Practice Manager not wanting
to change their flow of
documents/letters as part of the
project, and therefore not to
participate in the project.
24/08/2017
project manager to liaise with the practice
manager to confirm their position, and if their
position is unchanged it would not be appropriate
for them to take up training places that could be
available to the practices who are participating 31/12/2017 High closed GP Champion on board
Financial Issues receiving the funds from
HEKSS
24/08/2017
project manager to follow up with emails to
HEKSS, raise final invoice 30/09/2017 High closed Finance received fully
Delivery Training – We are not yet receiving
the Training providers presentations
in advance of the training delivery in
order to approve content. 19/10/2017
project manager has followed this up with training
provider and reminded them of this requirement. 29/11/2017
Presentations delivered but
still only just before the
training. Does not give us time
to make amendments. closed Training completed
Governance
concerns that background and
capability of individuals booking onto
the level 4 training, in terms of their
appropriateness and ability to
become a future ‘train the trainer’
which is the requirement of the level
4 training. 19/10/2017 validate the delegate appropriateness 21/11/2017
All Practice managers and
candidates booked on level 4
emailed. closed
Confirmation they
understand they will be
required to become future
'Train the trainer'.
Governance GPs not engaging with requests for help
with metrics
08.03.18
project manager to speak to practice managers,
expalin how useful the information is to the
Federation 15/03/2018
Project manager spoke to the
practice managers at the
Protected Learning Time closed
Project manager met the
PMs
Operational Project slippage on capturing post-
implementation data
19.04.18
post implementation evaluation data has not yet
been collected, questionnaires to be sent out to all
practices 20/04/2018
All questionnaires sent out to
all relevant parties closed completed
Issue log
Version Control
Version
Author
Date
Page 19 of 43
Appendix 3: Project Risk Register
Previous version date: 19.04.18
Next review: 24.05.18
Ris
k R
ef
Risk Owner Risk Category Risk Title Cause & Impact Mitigating Actions Action Owner Completion Date for Actions
A unique
coding that
allows the
risk to be
easily
identified
Job title of the person
responsible for the
management, monitoring
and control of the identified
risk
A statement describing risk event A statement describing the cause and Impact
Lik
elih
oo
d
Imp
act
RA
G S
tatu
s
Systems and processes that are in place and
operating that mitigate this risk, including
assurances
Job title of the person assigned to
carry out mitigating actions
For each mitigating action a
completion date must be provided
Lik
elih
oo
d
Imp
act
RA
G S
tatu
s
1 Governance
If demand for primary care is too high, GPs, admin supervisors, PMs may
not have the capacity to provide the level of supervision and support
required to individuals delivering the medical assistant role
Cause: practice too busy to provide adequate supervision
Impact: inadequate supervision and possible errors 3 5 15
continuous support to ensure staff are adequately
supervised
GP & PM Champions oversee trainees
Trainee forum Ongoing
1 3 3
2 Reputational
If training material is not up to standard it will impact negatively on both
trainees and project for level 3 & 4
Cause: trainer could provide non agreed training material
Impact: project failure 5 5 25
Ensure we see all training material before training
delivered.
Develop own training package 29th November 2017
31 January 2018
3 2 6
3 Strategic GPs might not buy in to project
Cause: Not wanting change
Impact: project failure 5 5 25 Transfer risk to Fed board 31st August 2017
1 1 1
4 Financial Not receive funding in a timely fashion
Cause: Complicated invoicing process
Impact: project failure 5 5 25 Escalate to KSS management team Closed
5 Governance
Delegates booked onto the level 4 training may not recognise the
expectation that they will be required to deliver future training
Cause:communication with delegates
Impact: Future training 3 5 15
validation of delegates on level 4 to ensure they are
suitable for the train the trainer programme. add a
question into the evaluation around preparedness to
deliver training to:
.New staff within your practice
. Staff within other Surrey Heath practices
. Staff within external practices.
30th November 2017
1 3 3
7 Operational
No external interest in the formal training package
Cause: No external interes
Impact: Part of the project fails financial impact due to building a package 3 5 15
Updated CCG's and Federations that we have our own
training package Ongoing 3 2 6
8
Version Control
Risk Score
Anticipated
Risk Score
Following
Mitigation
Version: V1
Author:
Date amended:
Page 20 of 43
Appendix 4: Project Lessons Learned Log
Medical Assistant Pilot
Surrey Heath Community Providers
Pilot of new way of working for document
management
ID Date
Identified
Entered
By
Project
Code
Subject Situation Recommendations & Comments Follow-up
needed? How has this been shared?
1 08.06.2017 n/a Plan anticipated that GPs would be keen to
become 'champions' for the work, which
would have been supported by bespoke GP
Champion training
Feedback from GP partners when testing
the concept was not positive intially.
We undertook specific engagement
via the GP Steering Group, which
has agreed that we should proceed
with GP Champion training.
Yes Training will be organised
2 08.06.2017 n/a Project Team planned for significant amount
of the training to be delivered prior to the
summer holiday period.
Found that this was too soon as it did not
allow sufficient time for engagement with
practices to ensure positive repsonse and
uptake of the training, and also staff
recruitment.
Additional communicaiton &
engagement with practice teams
prior to launching training. Delayed
start of training until September
2017 (after the main holiday period)
Yes Further practice engagment.
Re-book training
3 24.08.17 n/a Evaluation Forms Evaluation form required for the training to
gain data for KPI's
As good practice rather than start
from scratch project manager to ask
training provider to share a copy of
their training evaluation forms.
No
4 24.08.17 n/a Seek practice commitment during
engagement at the beginning of the process
One practice have reported not wanting to
change their flow of documents/letters as
part of the project and therefore not to
participate in the project. Would it be
relevant for their teams to attend training?
project manager to liaise with the
practice manager to confirm their
position, if their position is
unchanged it would not be
appropriate for them to take up
training places that could be
available to the practices who are
participating.
Yes Further practice engagment by
GP Project champion and
agree a plan to move the flow of
documents. Re-book training
places if necessary
5 19.10.17 n/a Training Levels It was recognised that communication
around the levels of training could have
been clearer
increased clarity of the levels of
training, and the implications of each
level, i.e. what would it mean for an
individual delegate. Improving the
pre-course and pre-booking
communication to delegates to
improve their understanding of what
they are joining. The learning is to
involve delegates at an earlier
time/before the training (i.e. don’t
wait to introduce the content and
learning outcomes until the first
No
6 19.10.17 n/a Level 4 Concern was raised over the type,
background and capability of individuals
booking onto the level 4 training, in terms
of their appropriateness and ability to
become a future ‘train the trainer’ which is
the requirement of the level 4 training.
Email to all delegates and Practice
Managers on the level 4 training,
clarifying the requirement to become
part of the train the trainer faculty
and deliver future training as new
staff join practices in the Federation.
Yes Further engagement with
Practice Managers to discuss
suitability of delegates and
ensure they understand they
will be the future trainers.
PROGRAMME LESSONS LEARNED LOGProject Name:
Project Manager Name:
Project Description:
Programme Name:
Page 21 of 43
Medical Assistant Pilot
Surrey Heath Community Providers
Pilot of new way of working for document
management
ID Date
Identified
Entered
By
Project
Code
Subject Situation Recommendations & Comments Follow-up
needed? How has this been shared?
7 19.10.17 n/a Training material Difficulty in obtaining training material
before each level to ensure the material
was satisfactory and relevant.
In relation to seeing the course
training material prior to the training
delivery, it would have been more
robust to stipulate need to see
training material prior to sign-off /
agreement to proceed with training
dates.
No Speak to training provider to
ensure training material is sent
to project team prior to training
sessions
8 19.10.17 n/a Evaluation Forms Following on from lessons learned log 3
we found that the Training provider did not
have an evaluation form for evaluating the
training only evaluates the trainer
Don’t rely on the quality of the
trainers’ standard evaluation form to
meet our needs. In future ask to
see their evaluation as part of their
training package prior to signing off
purchase of the programme.
No Design own evaluation form
9 21.11.17 n/a Number of delegates for each training level Requirement for level 3 &4 less than
expected
A knowledge of the training material
would have helped evaluate the
number of delegates required to
attend the levels.
No
10 21.11.17 n/a Soft - go live pilot soft-go live/pilot at one practice,
highlighted undue pressure on the
administrative staff. Extra work required by
the Practice Manager
The soft launch highlighted the need
to increase admin staff, a robust
support network for the trained
administrators and supervision is
required to take the pressure off the
admin staff
11 25.1.18 n/a GP Training GP training ran too late in the programme
should have been prior to admin training
In future training programmes run a
GP session before the admin
sessions
No
12 08.03.18 n/a Evaluation Forms 7 Feedback forms evaluation forms and feedback forms not
received from practices/GPs
would have been more effective to
incentivise critical returns
No
13 08.03.18 n/a Train the trainer internal and external training recognise that individuals who have
been trained to offer the training
package maybe more comfortable
delivering training internally and
others comfortable training external
delegates.
No
Project Name:
Programme Name:
Project Manager Name:
Project Description:
PROGRAMME LESSONS LEARNED LOG
Page 22 of 43
Appendix 5: Project Communication Plan
KEY AUDIENCES
/STAKEHOLDERS EVENT/MILESTO
NE /PHASE
COMMUNICATION
OBJECTIVE TACTICS/ COMMUNICATION
CHANNELS (TYPE
OF MEDIA)
KEY
MESSAGES WHO TO ACTION START AND STOP
DATES FREQUENCY
(HOW OFTEN TO
CARRY OUT THE
ACTIVITY)
GPs/PMs 14.07.17 Update GPs on project
PLT/GP Steering group/emails
Reduce GP workload
All 14.07.17 – 19.6.18
Quarterly meetings
Administrative staff
Advertise Training dates
Explain the course and offer relevant training dates
Via PMs, emails Benefits of training
Project manager
01.09.17 – 30.11.17
As required
Administrative staff Feedback on training
Outcome measurement
Email/ group discussion
Peer support Project team
GPs Feedback Outcome
measurement PLT For
information Project Team After project
closure
Other federations
Training package
Roll out training to other organisations
Initial email, follow up face to face
High quality training material
Trainer After project closure
Page 23 of 43
Appendix 6: Project Finance Allocation Expenditure
Training Provider £5,000
Backfill time to support GP, PMs & Admin staff £4,000
programme evaluation & development of Train the trainer £3,250
Project management £6,000
Cost of learning material for future Train the trainer programme £4,750
Venue & facility costs £2,500
Expected £25,500.00
Page 24 of 43
Appendix 7: Data collection template
Must always be
forwarded to GP
Send to other
clinical staff ie
Nurse
Send direct for
Read Coding /
File direct to
patients notes Comments
EXAMPLE - DM discharge letter P If action needed also pass to GP
EXAMPLE - Malignant Neoplasm P
Minor Injuries
Results:
Blood Abnormal
Radiology (x-ray, Ultrasound, MRI) Abnormal
Dexa scan Normal
Dexa scan Abnormal
National Screening results (bowel / Breast/ Cervical/AAA) Normal
Histology Normal
Histology Abormal
Scopes (Endocsopy, Colonoscopy, Gastroscopy, Sigmoidoscopy) Normal
Scopes (Endocsopy, Colonoscopy, Gastroscopy, Sigmoidoscopy) Abnormal
DM Retinal Screening
In - House Spiro / ECG / 24hr BP
Clinic Letters (NHS/Private):
No action required
Action required (TTO, Change in treatment, Referral)
Physio letters
Cancer Diagnosis
Live Birth Notification
Mother and Baby/Neonatal discharge
Ante Natal Booking
Nerve Conduction Studies
Miscarages / Termination
Family planning/vasectomy
Death Notification
Living Will / Advanced Decision Aids
DNACPR
DNA
Private well being clinics
Child Protection
Mental Health Routine
Mental Health (suicidal thoughts)
GOS18 (optician)
Admin letters from Jobcentre Plus
Hospice Care Admin
Admin letters from patients
A&E (over 16)
A&E (under 16)
111 / OOH/Woking walk in Centre
Results:
Blood Normal
Radiology (x-ray, Ultrasound, MRI) Normal
National Screening results (bowel / Breast/ Cervical/AAA) Abnormal
Cytology Normal
Cytology Abormal
Clinic Letters (NHS/Private):
Hospital (NHS/Private)Discharge
Drug and Alcohol Services
Ambulance reports
Learning Disability Service (speech & language)
Page 25 of 43
Appendix 8: Document Management Protocol
Protocol for Document Management
The following letters shall ALWAYS be forwarded to a GP as per the following list:
All new cancer diagnoses
All Child protection letters
Any letter of a patient having suicidal thoughts
Any A & E attendance sheets relating to a child (under 16), who has been attending more
than once in the past 3 months, or who has attended more than one A & E department in
different hospitals
DNA for vulnerable patients – Child/Care Home/Safeguarding
Abnormal blood results
Abnormal Radiology (x-ray, ultrasound, MRI)
Abnormal national screening results (bowel/breast/cervical/AAA
Dexa Scan results
Abnormal histology
Abnormal scopes (Endoscopy, Colonoscopy, Gastroscopy, Sigmoidoscopy)
Abnormal Cytology
In-House Spiro/ECG/24hr BP
Any letters or communications requiring follow ups, e.g. new diagnosis, further tests, TTO,
Change in treatment, referrals etc
Nerve conduction studies
Death notification
Hospice care admin
Admin letters from patients
Hospital discharge letters with actions
Ambulance reports
Learning disability service (speech & language)
The following letters/ information/data/results can be coded where possible:
Minor injuries
Normal national screening results (bowel/breast/cervical/AAA)
Normal Histology
Normal blood results
Normal Radiology (x-ray, ultrasound, MRI)
Normal scopes (Endoscopy, Colonoscopy, Gastroscopy, Sigmoidoscopy)
Normal cytology
DM Retinal Screening
Clinic letters with no action required
Physio letters with no action required
111/OOH/Woking walk in Centre
Live birth notification
Mother and baby/neonatal discharge
Page 26 of 43
Antenatal bookings
Miscarriages/terminations
Any A & E attendance sheets relating to over 16’s
Family planning/vasectomy
Living will/advanced Decision Aids
DNACPR
DNA other than vulnerable patients
Private wellbeing clinics
Mental health review or care plans should be coded appropriately as review or care plan
GOS18 (Optician) unless referral is urgent
Letters with up to date test results, exercise, height, weight and other measurements are
recorded, code into notes.
Hospital discharge letter no action required
Drug and alcohol services
These instructions are not totally comprehensive. As new issues arise this policy should be
amended.
Any letter you are not certain about MUST go to the relevant GP with a request
for advice and when returned code accordingly.
These actions can also lead to amendment to policy.
Page 27 of 43
Appendix 9: Post-Training Survey Responses – Level 1
Correspondence Management
Please take a few minutes before the start of this training session to complete the following
questionnaire. The intention is to help us establish a baseline of understanding before the session
which we will then revisit at the end of the session to gauge the difference it has made.
Did you nominate yourself for this course or were you chosen by your Manager (please circle yours
answer below) Self - 1 Manager - 33
1 Are you aware that the Correspondence Management course you are attending is a pilot and that we are one of 5 pilot sites nationally (please circle your answer below)
Before training Yes - 14 No - 20 After Training Yes - 33 No
2. How would you rate your understanding of what Correspondence Management is (please circle your rating below 1 being very low - 6 being very high)
Before training
2.94
After Training 5.06
3. How would you rate the potential for Correspondence Management to make a real difference to how your Practice presently works (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.47
After Training 5
4. How would you rate the potential for Correspondence management to improve the quality of patient care your practice offers (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.26
After Training 4.88
5. How would you rate the potential for Correspondence Management to make better use of GP time in your Practice (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.91
After Training 5.21
Page 28 of 43
6. How would you rate the potential for Correspondence Management to increase your level of Job Satisfaction (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.09
After Training 4.26
7. How would you rate the likelihood of your Practice changing how it works as a result of you attending this training (please circle your rating below - 1 being not at all - 6 being highly
likely) Before training
3.38
After Training 4.21
8. How appropriate for your current job is this training (please circle your rating below - 1 being
very low - 6 being very high) Before training
3.71
After Training 4.44
Page 29 of 43
Appendix 10: Post-Training Survey Responses – Level 2
Correspondence Management
Level 2
Please take a few minutes before the start of this training session to complete the following
questionnaire. The intention is to help us establish a baseline of understanding before the session
which we will then revisit at the end of the session to gauge the difference it has made.
Did you nominate yourself for this course or were you chosen by your boss (please circle yours answer
below) Self - 3 Manager - 39
1 If you haven’t attended level 1, are you aware that the Correspondence Management course you are attending is a pilot and that we are one of 5 pilot sites nationally (please circle your answer below)
Before training Yes - 12 No – 15 Left blank -15 After Training Yes - 21 No – 0 Left blank - 21
2. If you haven’t attended level 1, how would you rate your understanding of what Correspondence Management is (please circle your rating below 1 being very low - 6 being very high)
Before training
2.4
After Training 5.42
3. How would you rate the potential for Correspondence Management to make a real difference to how your Practice presently works (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.76
After Training 5.02
4. How would you you rate the potential for Correspondence management to improve the quality of service your Practice presently offers your patients (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.79
After Training 4.85
5. How would you rate the potential for Correspondence Management to make better use of GP time in your Practice (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.94
Page 30 of 43
6. How would you rate the potential for Correspondence Management to increase your level of Job Satisfaction (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.37
After Training 4.26
7. How would you rate the likelihood of your Practice changing how it works as a result of you attending this training (please circle your rating below - 1 being not at all - 6 being highly
likely) Before training
3.72
After Training 4.80
8. How appropriate for your current job is this training (please circle your rating below - 1 being
very low - 6 being very high) Before training
3.73
After Training 4.70
After Training 5.24
Page 31 of 43
Appendix 11: Post-Training Survey Responses – Level 3
Correspondence Management
Please take a few minutes before the start of this training session to complete the following
questionnaire. The intention is to help us establish a baseline of understanding before the session
which we will then revisit at the end of the session to gauge the difference it has made.
Did you nominate yourself for this course or were you chosen by your Manager (please circle yours
answer below) Self - 7 Manager - 17
1. If you haven’t attended level 1 or 2, how would you rate your understanding of what Correspondence Management is (please circle your rating below 1 being very low - 6 being very high)
Before training
4.22
After Training 5.11
2. How would you rate the potential for Correspondence Management to make a real difference to how your Practice presently works (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.95
After Training 5
3. How would you rate the potential for Correspondence management to improve the quality of service your practice presently offers your patients (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.95
After Training 4.78
4. How would you rate the potential for Correspondence Management to make better use of GP time in your Practice (please circle your rating below - 1 being very low - 6 being
very high) Before training
4.5
After Training 5.3
Page 32 of 43
5. How would you rate the potential for Correspondence Management to increase your level of Job Satisfaction (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.62
After Training 4.34
6. How would you rate the likelihood of your Practice changing how it works as a result of you attending this training (please circle your rating below - 1 being not at all - 6 being highly
likely) Before training
4.25
After Training 5
7. How appropriate for your current job is this training (please circle your rating below - 1 being
very low - 6 being very high) Before training
4.66
After Training 5
Page 33 of 43
Appendix 12: Post-Training Survey Responses – Level 4
Correspondence Management
Please take a few minutes before the start of this training session to complete the following
questionnaire. The intention is to help us establish a baseline of understanding before the session
which we will then revisit at the end of the session to gauge the difference it has made.
Did you nominate yourself for this course or were you chosen by your Manager (please circle yours
answer below) Self - 6 Manager - 10
1. Now that you are on Level 4, How would you rate the potential for Correspondence management to improve the quality of service your practice presently offers your patients (please circle your rating below 1 being very low - 6 being very high)
Before training
3.57
After Training 5.06
2. How would you rate the potential for Correspondence Management to make better use of GP time in your Practice (please circle your rating below 1 being very low - 6 being very high)
Before training
3.64
After Training 5.25
3. How would you rate the potential for Correspondence management to increase your level of job satisfaction (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.07
After Training 4.21
4. How would you rate the potential for Correspondence Management to increase the level of job satisfaction within your team (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.23
After Training 4.2
Page 34 of 43
5. How appropriate for your current job is this training (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.21
After Training 4.66
6. Were you aware there was a ‘train the trainer’ element to level 4 Yes 11 No Blank
2 3
7. How do you feel about being a correspondence management trainer (please circle your rating below - 1 being very low - 6 being very high)
Before training
3.57
After Training 4.81
Page 35 of 43
Appendix 13: Benefits Dependency Network
Page 36 of 43
Appendix 14: Delegate Post-Programme Questionnaire – Administrative & Clerical Staff
Name:
In which GP Practice do you work?
Please describe what your current role involves, highlight what has changed since you enrolled on
the programme.
What do you feel you have achieved during this programme with regards to the following domains:
personal, professional (knowledge and skills) and social/networking?
Medical Assistant: Delegates Post-Programme Questionnaire
Personal:
Professional:
Social/networking:
Page 37 of 43
Reflecting on your overall experience of the programme, to what extent do you agree or disagree
with the following statements:-
Disagree Somewhat disagree
Somewhat agree Agree
I was motivated to study on this programme o o o o I was well prepared to study on this programme o o o o I knew what was expected of me o o o o I had scheduled protected work time in my calendar for this programme
o o o o I felt supported by my manager o o o o I felt supported by my colleagues o o o o The information I received was useful o o o o The programme was appropriate for my role as medical assistant o o o o
Now that you have completed the programme, is there any additional information that you feel
would have been useful to receive before commencement of the programme?
Page 38 of 43
What other skills or knowledge relevant to your role as Medical Assistant have you developed
through participating in this programme?
To what extent has your participation in the programme had a positive impact on the following
people in your work environment.
No Impact Minor Impact
Impact Major Impact
Yourself o o o o The Clinicians o o o o The Managers o o o o The Patients o o o o The carers o o o o
Reflecting on your responses to the previous please provide examples of the positive impacts of your
participation in the programme on the people in your environment
Page 39 of 43
What is your biggest achievement since you started the programme?
Thinking further about the impact of the programme on your experience at work, to what extent do
you agree with the following statements?
Disagree Somewhat disagree
Somewhat agree Agree
My work has become more varied o o o o
My work has become more interesting o o o o
I am more motivated in my work o o o o
I am more confident in carrying out my work o o o o
I am more satisfied with my work o o o o
I am more likely to stay in this work setting o o o o I have been given more responsibilities at work o o o o I feel I am more proactive and able to take the initiative at work o o o o I am able to manage my workload more efficiently o o o o
I have more interest in further learning o o o o
I feel I now contribute more to patient care o o o o
Page 40 of 43
How else has your participation in the programme impacted the way you work? Please describe and
give details.
How do you hope your career will progress now that the programme has finished?
What has been the most challenging aspect of the programme?
What did you like most about the programme?
Do you have any suggestions for improving the programme?
Page 41 of 43
To what extent do you agree with the following statements related to the sustainability of this
programme.
Disagree Somewhat disagree
Somewhat agree Agree
This programme was good investment of my time o o o o I would recommend this programme to my colleagues o o o o I would be interested in enrolling on similar programmes o o o o This programme has improved my career opportunities o o o o This programme could have a significant impact on my career progression in the future o o o o Is there any other support we can give you?
Page 42 of 43
Appendix 15: Delegate Post-Programme Questionnaire – GPs
Name:
In which GP Practice do you
work?
To what extent do you agree or disagree with the following statements regarding the programme?
Disagree Somewhat disagree
Somewhat agree Agree
I spend less time on correspondence since the programme started? o o o o
I have more time for other clinical duties? o o o o The programme has had a positive impact on my working day? o o o o Please provide a few examples of positive or negative impacts reflecting on your responses to the
previous question.
Medical Assistant: GPs Post-Programme Questionnaire
Page 43 of 43
Is there anything else you would like to tell us that you feel is important for the evaluation?